Intraventricular meningioma

Case contributed by A.Prof Frank Gaillard

Presentation

Headache.

Patient Data

Age: 35 years
Gender: Female
Modality: MRI

Centred within the trigone of the left lateral ventricle is a large rounded vividly enhancing homogeneous mass surrounded by a some high T2 signal within the white matter of the temporal parietal lobes consistent with vasogenic oedema. It is clearly intraventricular, is isointense to grey matter on T1 and T2-weighted sequences and demonstrates moderate diffusion restriction and elevated cerebral blood volume of blood flow on perfusion.

In the floor of the left middle cranial fossa is an extra-axial well-circumscribed vividly enhancing lesion with similar signal intensity, associated with minor hyperostosis, characteristic of a meningioma. The remainder of the brain is unremarkable in appearance.

Conclusion:

Left trigonal intraventricular lesion almost certainly represents an intraventricular meningioma. Second smaller middle cranial fossa meningioma in the middle cranial fossa.

Case Discussion

The patient went on to have a resection. 

Histology

MICROSCOPIC DESCRIPTION:

Sections show a well-circumscribed moderately hypercellular meningioma with a mixed meningothelial and fibroblastic architecture. Tumour is partially surrounded by a dense fibrous capsule with focal papillary excrescences resembling choroid plexus. Tumour cells demonstrate uniform nuclear features. Frequent psammoma bodies are present. No mitoses or areas of necrosis are identified. There is no evidence of brain invasion.

DIAGNOSIS: Meningioma (WHO Grade I).

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Case Information

rID: 51544
Case created: 24th Feb 2017
Last edited: 2nd Mar 2017
Inclusion in quiz mode: Included

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